Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Oct 2003
Review[Gastrointestinal tonometry: a new tool for the anesthesiologist].
Intestinal hypoperfusion is among the factors implicated in sepsis and multiorgan failure. Splanchnic blood flow may be sacrificed to maintain supply to vital organs, even when hemodynamic alterations are minor. The sensitivity of invasive hemodynamic monitoring for detecting intestinal hypoperfusion is low. ⋯ We review the pathophysiology of ischemic intestinal lesions, the basis for gastrointestinal tonometry, and the method. Finally we discuss clinical applications (early diagnosis of ischemic colitis and ischemia of the flap after esophageal reconstruction, weaning from mechanical ventilation, abdominal compartment syndrome, liver transplant, heart surgery, prognostic factors and care of the critically ill patient). An adequate understanding of this monitoring technique and management of information it provides can give an early warning of the intestinal hypoperfusion that precedes other serious systemic complications.
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Rev Esp Anestesiol Reanim · Jun 2003
Review[Complications during epilepsy surgery. Experience after 102 interventions between 1997 and 2001].
To describe perioperative complications in different approaches to surgery for epilepsy. ⋯ The rate of perioperative complications in surgery for drug-resistant epilepsy is low, the most common complication being self-limiting bradycardia related to surgical maneuvers.
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Regional anesthesia for ophthalmic procedures has changed significantly in the past ten years. Phacoemulsification for cataract surgery through corneal microincisions, soft foldable lenses and topical anesthesia simplify surgery such that most operations can be performed on an outpatient basis. Some anesthetic blocks are performed by either anesthesiologists or ophthalmologists, who should understand the advantages and disadvantages for each patient. This review discusses anatomical aspects of interest to the anesthesiologist, the main techniques used and anesthetic innovations, complications and certain controversies such as management of the patient who is taking medications that alter hemostasis, the withdrawal of hyaluronidase in some countries and the systematic ordering of tests before the procedure.
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Rev Esp Anestesiol Reanim · Apr 2003
Review[Non-therapeutic intraoperative hypothermia: prevention and treatment (part II)].
General and regional anesthesia alter the physiological mechanisms of thermoregulation, and unintentional intraoperative hypothermia develops during most surgical procedures that last more than 1 hour. Monitoring of central temperatures among other vital signs is advisable in such interventions in order to detect temperature changes and check the efficacy of measures to prevent or treat hypothermia. ⋯ The most often used are forced-air or warm water circulation devices. When large volumes of fluids must be infused intravenously, they must be warmed to body temperature to avoid heat loss.